Hot Flash

Hot Flash

You can enjoy life while going through perimenopause

She began having hot flashes at age 48, as did many of her female friends.

Since it often happened when I was drinking a glass of wine, I dismissed it,” said Tina, a 51-year-old patient of Denise Meckler, OB/GYN at Missouri Baptist Medical Center.
But then came sleep problems.

“I’d sleep 45 minutes and wake up, lying there for an hour before falling back asleep. This would go on all night. I actually felt lucky if I got a total of four or five hours of restful sleep each night.”
At first she thought, ‘oh, well, this is life.’

But sleep deprivation made her irritable and was affecting her attitude and her job.
Tina knew she had to talk to her physician about the symptoms. “I’ve seen Dr. Meckler for a lot more than just my annual pap smears over the last few years,” she said.

“You don’t have to live with perimenopausal symptoms,” Tina advised. “Talk to your doctor openly. They are there to help. If you don’t have a doctor you can comfortably talk to, find another one.”

When is Perimenopause?

“Perimenopause can begin around age 45 and is about a five-year transition period prior to reaching menopause,” said Dr. Meckler. “The average age of menopause is 51, and is considered the point at which a woman is without a menstrual cycle for a complete year.”

Dr. Meckler, who is in her mid-40s, said she can relate to what her patients are going through.
She explained that women sometimes are apprehensive about perimenopause and menopause because they receive so much information and misinformation from friends and the media.

“Friends may talk about what’s true for them, or even exaggerate how they have horrible moods, no interest in sex, and hot sweats that make them want to strip in public.”

“Yet, not all women experience perimenopause the same way. In fact, many women go through the stage gracefully,” said Dr. Meckler. “And, there are lots of tricks and remedies to help.”

Fooling Mother Nature

“To help stop hot flashes and night sweats, I recommend my patients avoid red wine in particular and not drink caffeine,” said Dr. Meckler. She also said it can help to take black cohosh, a nutritional supplement, and/or flax seed oil.

Tina said, “I cut back on alcohol, which makes a difference. I know that after my first sips of wine, I risk needing to stand in front of the refrigerator!”

She laughed, “I also started sleeping without clothes on, which my husband thinks is awesome!”

“Aromatherapy, especially the scent of lavender, can help with sleep,” said Dr. Meckler. “I also am a big believer in hormone therapy.”

She added that hormone therapy is something that needs to be discussed on an individual patient basis as it is not for everyone. While still in the perimenopausal stage, low dose birth control pills can help mask hot flashes and night sweats, as well as provide contraception and cycle control.

Dr. Meckler offered other suggestions as well. Besides calcium, women should take a Vitamin D supplement, which helps maintain bone density as well as memory. She said forgetfulness is a common complaint from patients.

“If a woman is really miserable and not functioning, that’s often when hormones come into play,” said Dr. Meckler. Hormones are available in pills, patches and topical creams, as well as vaginal preparations.

“It’s important that women communicate with their doctor and try alternatives until they find something that works for them,” said Dr. Meckler.

Tina is on a low dose oral hormone supplement. “What a difference that makes!” she said.

“At first, I was reluctant to take them because of the media, but decided there is a reason pharmaceuticals are on this earth. Now I embrace it. In less than a week, my hot flashes stopped and I was able to sleep seven to eight hours a night.”

Hormone therapy also helped Tina sexually.

Prior to hormones, intercourse could be painful even with over-the-counter lubricants. “Now with the hormones, it’s a non-issue,” she said.

Fighting Weight Gain

“Many women worry about weight gain in menopause,” said Dr. Meckler. “Our metabolism slows, we often have less energy and are less active. We may be more social at this stage with no kids at home and eat out more often, where we tend to eat more.” Weight gain, usually in the mid-section, may happen with or without hormones during menopause.

“I recommend women eat healthy and do exercises to strengthen their core, as well as watch their posture,” said Dr. Meckler.

“I’ve increased my exercise,” said Tina. “It makes me feel better – all those endorphins – and I know people who exercise tend to be healthier.”

Controlling the weight changes was a real frustration. “I didn’t change my caloric intake, and yet the fat developed around my stomach,” she said. “My weight shifted.”

“I joined a weight loss program and since then have lost about 10 pounds. But I still wear the same size pants. My butt is flatter and my thighs smaller, while the waist band is the same.”

In Tina’s opinion, one needs to lose weight all over if they wish to maintain their premenopausal size. “Now I will grab strawberries or a banana versus that bagel,” she said.

Be Aware of Other Health Risks

Dr. Meckler said she addresses weight, as well as blood pressure, diabetes and heart disease with her patients.

“Many women do not have an internist and only see their OB/GYN. I recommend women find an internist, too.”

“Mammograms become more important, also, as breast cancer risk starts to increase every year,” she said.

Addressing another issue, Dr. Meckler said, “Women who smoke usually go through menopause earlier. They have fewer options during the change, and are at risk for lung cancer and other diseases, as well as wrinkles and dry skin.”

Overcome Dry Skin and Hair

With hormones and vitamins, Tina also said that her hair, skin and fingernails are better. In addition, she uses a deep conditioner on her hair two to three times a week. “Although it is more often than the jar recommends, it really helps.”

“I changed my facial care completely. I use more creams and am religious about taking my makeup off with a cleanser and not just soap,” said Tina.

During the day, she uses a line diminisher, then a moisturizer on top. At night, she uses a retinol cream to fight wrinkles.

It’s Just Another Stage of Life

Dr. Meckler, who is married with two pre-teens, reminds us that perimenopause/ menopause is just another stage of life, and often one to be embraced.

Although perimenopause has been full of symptoms for Tina, she has other friends who are struggling with breast cancer.

“I’m just grateful to be alive and I try to make each day a positive experience.”

Denise Meckler, MD, is a board-certified OB/GYN, on staff at Missouri Baptist Medical Center and a member of BJC Medical Group. She received her medical degree from The Ohio State Medical School in Columbus and completed her residency at Barnes-Jewish Hospital and Washington University School of Medicine.

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